Provider Demographics
NPI:1659449403
Name:DENSON, RAY ANDERS (DO)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:ANDERS
Last Name:DENSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029
Mailing Address - Country:US
Mailing Address - Phone:713-453-0404
Mailing Address - Fax:713-453-3577
Practice Address - Street 1:1414 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029
Practice Address - Country:US
Practice Address - Phone:713-453-0404
Practice Address - Fax:713-453-3577
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8693207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A66168Medicare UPIN
89170FMedicare ID - Type Unspecified